{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:33:58Z","timestamp":1791938038634,"version":"4.3.4"},"reference-count":19,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,2,26]],"date-time":"2018-02-26T00:00:00Z","timestamp":1519603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Delays in postoperative head and neck (HN) radiotherapy have been associated with decreased overall survival; however, the impact of delays in postoperative HN chemoradiotherapy remains undefined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients with nonmetastatic HN cancer (oral cavity, oropharynx, larynx, hypopharynx) who underwent curative intent surgery and received adjuvant chemoradiotherapy were identified from the National Cancer Database (2005\u20132012). Overall treatment time (OTT) was defined as the time from surgery to the end of radiation therapy. Statistical methods included Cox proportional hazards modeling, which adjusted for clinicopathologic, demographic, and socioeconomic factors. Recursive partitioning analysis (RPA) identified the optimal threshold of OTT via conditional inference trees to estimate the greatest differences in overall survival (OS) on the basis of randomly selected training and validation sets.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 16,733 patients were included, with a median follow\u2010up of 37 months. Median OS for OTT in a predefined threshold of\u2009\u2264\u200913 weeks was 10.1 years (95% confidence interval [CI], 9.8 years; not reached) compared with 8.7 years (95% CI, 8.2\u20139.2 years) in\u2009&gt;\u200913 weeks. On multivariate analysis, OTT of\u2009&gt;\u200913 weeks versus\u2009\u2264\u200913 weeks independently increased mortality risk (hazard ratio, 1.10; 95% CI, 1.04\u20131.17; <jats:italic>P<\/jats:italic>\u2009=\u2009&lt;\u20090.001). RPA identified an optimal OTT threshold of 97 days (interquartile range: 96\u201398 days). The OTT threshold of 97 days was confirmed in a full Cox regression model estimating the risk of death according to overall treatment time as a continuous variable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this large hospital\u2010based national data, an OTT of greater than approximately 14 weeks most consistently increased the risk of death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 128:2326\u20132332, 2018<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27152","type":"journal-article","created":{"date-parts":[[2018,2,26]],"date-time":"2018-02-26T20:00:28Z","timestamp":1519675228000},"page":"2326-2332","source":"Crossref","is-referenced-by-count":37,"title":["The impact of adjuvant chemoradiotherapy timing on survival of head and neck cancers"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2011-4211","authenticated-orcid":false,"given":"Moses","family":"Tam","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology New York University Langone Health  New York U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Peter","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology New York University Langone Health  New York U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naamit K.","family":"Gerber","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology New York University Langone Health  New York U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, SUNY Downstate Medical Center  New York U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Schreiber","sequence":"additional","affiliation":[{"name":"Veterans Affairs NY Harbor Healthcare System Brooklyn New York U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8221-5077","authenticated-orcid":false,"given":"Babak","family":"Givi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery New York University School of Medicine  New York U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology New York University Langone Health  New York U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,2,26]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(01)01690-X"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032641"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032646"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20279"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.21.4197"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-009-0771-3"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/02841868809090333"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-8140(97)01904-X"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19920601)69:11<2744::AID-CNCR2820691119>3.0.CO;2-U"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30939"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29191"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa012337"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.25364"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70290-4"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.3109\/0284186X.2010.551139"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2011.92"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.55.6258"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2016.017863"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0912217"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.27152","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.27152","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T17:46:09Z","timestamp":1694886369000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.27152"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,26]]},"references-count":19,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2018,10]]}},"alternative-id":["10.1002\/lary.27152"],"URL":"https:\/\/doi.org\/10.1002\/lary.27152","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,26]]}}}